Sitting on a colic

Well, I'm sitting here in medical records. What am I sitting on? Literally or figuratively? Literally I'm sitting on a stool at a computer. Figuratively, I'm sitting on a colic. That means, I'm waiting to see if it needs to go to surgery or not.

Now on some level, every colic is exactly the same.  For those of you who don't know, a horse that is colicking is a horse with a belly ache.  I could go into all the details of extra-gastrointestinal reasons for colic, gastrointestinal reasons for colic, colic of the small intestine, colic of the large intestine, strangulating vs. non-strangulating but suffice it to say that a colic can be caused by many things.

Likewise, the horses show up with varying clinical signs. This last weekend I received 5 colics. . . . I'm just going to let that sink in with you. 5. 5 colics. Okay lets move on. So I had these 5 sick horses show up over the weekend and this was what they looked like.


Horse 1: Looked a little crampy, a little bit sweaty, and needed sedation to stay comfortable.


What Horse 1 looked like (not actually horse 1)

Horse 2: Looked like it was put out at having been dragged out of bed at this hour. Couldn't, for the life of it figure out what we were doing or why.

What horse 2 looked like (not actually horse 2)

Horse 3: Arrived agitated and threatened to do several of us bodily harm because he was scared. Became painful enough to kick out while in the stocks. . . very nearly taking my femur with him, and needed sedation to calm down.


What horse 3 acted like (not actually horse 3)

Horse 4: Showed up in a full body sweat. This horse was attempting to throw itself down onto the ground in fits of pain and was refractory to all but the strongest of pain medications we could give it intravenously.

What Horse 4 looked like (not actually horse 5)

Horse 5: Arrived at 5am (sad face). This horse was more worried about the muzzle we put on its nose, than its belly ache.

What Horse 5 looked like (not actually horse 5)

So there you have it, the spectrum. Generally speaking we think of horses with worse lesions being more painful. "Wow, did you go to vet school to learn that kind of logic doc?" BUT! These are horses. . . so that's not always the case!

Lets look at our 5 horses and where they are at. . . 5-6 days later.

Horse 1: Horse one is doing well. She is happy eating in her stall as we speak and should be going home relatively soon. That sort of makes sense.

Horse 2: Horse 2 is still in the hospital as well. However, it looks like either secondary to or as the primary cause of her colic, she may break with colitis. She has developed fevers and is quite sick. Unexpected, is it not?

Horse 3: Horse 3 never acted colicky after his initial presentation. We sent him home very quickly because there was nothing that needed to be done. 1 day later, he was back and has since demonstrated the "colic" behavior that the owner described.  However, this behavior may not in fact be colic at all but seizure or some other type of hyperesthesia (hypersensitivity).

Horse 4: This horse was so painful we were drowing her in pain medications. She needed to go to surgery but the owner really couldn't afford it (understandable because the average colic surgery is approximately $8000 dollars). We didn't give her much of a chance with her level of pain and I was sure I would get a call around 2am to come and put her down.  Yet, when I walked in the next morning, there she was, standing, bright, alert and comfortable. Well bust my buttons was I surprised. She continues to do well.

Horse 5: Discharged 2 days later with no complications and happy as can be.

Suffice it to say, you just never can be 100% certain with a colic. They'll surprise you.
So as I sit here. . . I wonder. . . where will this horse come out? Will we have to take him to surgery? Will he buck up and come through on his own? How much longer do I have to sit here, before I get to go to bed? Can I sleep on a stool in an upright position?